Many are not convinced the glittering promise of genetic manipulation implies the presence of a pot of gold. Science often moves faster than moral understanding. For some, the gift of life is paramount. Children should be appreciated as the gifts they are. If we are seduced by the sirens of science, the breakdown of society will ensue and social solidarity will dissolve.

There is a wider benefit. Good genes over time create fitter humans — the entire gene pool could become optimized over a handful of generations. Certainly, such humans would have genomes qualitatively and quantitatively different from the genomes of 10,000 years ago. But over evolutionary time, viruses infiltrate our nuclei and update our 3 billion base pairs. Again, systematization of this "creation"-based process could provide great benefit.

The Alden March Bioethics Institute offers graduate online masters in bioethics programs. For more information on the AMBI master of bioethics online program, please visit the AMBI site.

Frankenstein, written by Mary Shelley in 1818, is as compelling and thought-provoking in 2011 as when the novel appeared almost 200 years ago. Shelley subtitled her opus The Modern Prometheus. Dr. Victor Frankenstein, although certainly no god, was a brilliant scientist who paid bitterly for the fruits of his genius. His loved ones were tragically murdered by his inhuman creation and he was doomed to suffer relentlessly for his deeds, as was Prometheus.

One possible conclusion from Shelley’s cautionary tale is that science should never proceed unchecked. Science always needs to be constrained by moral principles and its activities need to be referenced against potential harms. Frankenstein’s hubris blinded him to the likely untoward outcomes of his research. He was only focused on the task he had set himself. He gave no thought to what such a creature would think or how it would act. He certainly never considered potential consequences to others that would flow from the existence of such a creation.

The Alden March Bioethics Institute offers graduate online masters in bioethics programs. For more information on the AMBI master of bioethics online program, please visit the AMBI site.

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Dr. Adina Roskies is Associate Professor in the Department of Philosophy at Dartmouth College. Her areas of specialization are Philosophy of Science, Philosophy of Cognitive Science, and Philosophy of Mind.

Dr. Roskies was Project Fellow on the MacArthur Project in Law and Neuroscience from 2007 through 2010. Her recent publications include Neuroscientific challenges to free will and responsibility, published in Trends in Cognitive Sciences; “Neuroethics beyond genethics”, published in EMBO Reports; and Neuroimaging and inferential distance, published in Neuroethics.

In our 5-3-2011 BIOETHICS TODAY conversation, Dr. Roskies discusses

• Free will and determinism
• Compatibilism and incompatibilism
• Neuroscience–the brain as a mechanism
• Can the brain cause behavior?
• Neuroscience, determinism, and moral responsibility
• Neuroscience and the law

The Alden March Bioethics Institute offers graduate online masters in bioethics programs. For more information on the AMBI master of bioethics online program, please visit the AMBI site.

A bioethicist, obviously, is a person who practices bioethics. But what does this entail? On one hand, bioethics could be narrowly construed as focusing on medical ethics. A broader perspective exists, based on an expansion of bioethics to "biological ethics". Both frameworks, the narrow and the broad, are eminently valid and neither needs to exclude the other.

The need for bioethics and bioethicists is greater now than ever. Bioethicists are able to offer substantial value to communities at all levels, ranging from the level of the individual (a community of one) to the level of the planet (a global community), conceived as an intricately interwoven biosphere.

Let's get specific. What are the kinds of things that bioethicists do?

A bioethicist could be a member of a hospital staff and function as a clinical consultant. Bioethics consultations facilitate patient care in

• Determining capacity/competency related to making an informed choice
• End-of-life planning and decision making
• Determinations of medical futility
• Assisting families in making decisions regarding withdrawal of life support

A bioethicist may also function as an ombudsman for the patient and family, helping to establish ongoing clear and effective communication among all concerned parties. Depending on the context and the need, she would consult with the patient, the patient's family, medical staff, and administrative personnel.

In such a practice, the bioethicist is applying daily the principles of autonomy, beneficence, nonmaleficence, and justice. He is engaged in rewarding, exciting, ever-changing work with real people grappling with real, life-impacting challenges. Every day presents new opportunities to help make a meaningful difference at an individual, family, and community level.

And, much more is possible. Bioethics need not be restricted to the medical arena. Looking beyond the world of hospital practice, there are an abundance of opportunities for the bioethicist to paint with a broader brush.

For example, what are the responsibilities and accountabilities of global pharmaceutical companies? Almost 3 billion people worldwide live on less than $2 per day. These persons do not have the wherewithal to afford life-saving medications. The pharmaceutical giants are very glad to conduct clinical trials in developing nations where the costs of doing business are substantially lower than in their home countries. But these companies do not reciprocate and provide drugs at cost to indigent communities and societies. Bioethicists can help create policies focusing on distributive justice to be implemented by multinational pharmaceutical corporations.

The fields of wildlife conservation, sustainability, and renewable resources could all be enhanced by bioethics-informed policy. Human health and welfare depend not only on our interactions with each other. If bioethics intends to support the thriving of humans, it necessarily intends to support the thriving of redwood forests, coral reefs, butterflies and bumblebees, songbirds, and tuna and salmon. Natural capital and ecological services are valued at many trillions of dollars annually. Each of the four iconic bioethical principles is intimately related to maintenance and support of our natural world.

Bioethicists may work in universities, hospitals, all levels of government, policy institutes, and NGOs. Importantly, bioethicists could also work in corporations. What sort of corporation—national or multinational—would hire a bioethicist? If the corporation’s sole interest is its bottom line, i.e., profit and shareholder dividends, bioethics would most likely not fit into its strategy.

But a corporation’s board could have a different vision. Such a board could understand that the organization's long-range welfare is closely tied to the global economy, which is closely tied to the welfare and productivity of all populations, which is closely tied to ensuring the ongoing viability of environmental resources and ecological services. Such a corporation’s goals would be greatly furthered and assisted by having bioethicists on staff.

Too often, an observer of the field gets the impression that bioethics is primarily concerned with parsing ever finer notions of patient autonomy. On this view, it is IRBs rather than angels which are dancing on the head of a pin. Switching metaphors, such navel-gazing helps no one, except to provide meager support for struggling academic careers.

Bioethics is not this. Bioethics is the broad end of the funnel. Almost 50 years ago in his famous book Love and Will, the American psychologist Rollo May described the transitional nature of then-modern 1960s society. Those transitional qualities have persisted rather than resolved. The global economy is in crisis. Global climate change is apparent. Environmental resources and species diversity are at great risk. Health care, as such, is unrecognizable compared to 50 years ago, and not in a good way.

Bioethics and bioethicists can provide unique perspectives and original solutions in helping resolve the diverse challenges facing not only the United States but our global society. Bioethics and bioethicists can participate fully and become critical assets in humanity's search for meaning, self-realization, and discovery of arete.

The Alden March Bioethics Institute offers graduate online masters in bioethics programs. For more information on the AMBI master of bioethics online program, please visit the AMBI site.

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Philip Ball is the author of the new book, Unnatural: The Heretical Idea of Making People. Unnatural is published by The Bodley Head, a division of Random House. Philip Ball is a freelance writer. He previously worked for over 20 years as an editor for the international science journal Nature. His book Critical Mass won the 2005 Aventis Prize for Science Books. Philip’s other books include Bright Earth: The Invention of Colour and The Music Instinct.

In our 5-3-2011 BIOETHICS TODAY conversation, Philip Ball discusses

• The relevance of the idea of artificlal procreation for society today
• In vitro fertilization, embryonic stem cell research, cloning
• The intrusions of myth and legend in policy discussions involving research in the fields of reproductive medicine and regenerative medicine
• Our fears and assumptions about making people using artificial means – "anthropoiesis"
• How the term "unnatural" may be a moral judgment, involving both metaphysics and a "perpetually uneasy relationship with techne"
• Should limits be imposed on technology?
• Considerations of human uniqueness and the context for the emergence of new technologies

The Alden March Bioethics Institute offers graduate online masters in bioethics programs.  For more information on the AMBI master of bioethics online program, please visit the AMBI site.

Bioethics Today — A Manifesto

The field of bioethics is in the right place at the right time. The right place is at the intersection of medical practice, health care delivery, health care policy, and development of clinical guidelines and standards of care. The right place includes bioengineering, nanotechnology, pharmaceutical R&D, and environmental conservation and sustainability. Bioethics concerns range far afield, encompassing reproductive medicine, regenerative medicine, stem cell research, and man–machine interfaces.

Bioethics investigates and explores the underpinnings, ramifications, and implications of democracy, human rights, freedom of the individual, the existence of free will, and the origins and implementations of moral and ethical systems.

The right time for bioethics is right now. The present moment. The great philosopher Arthur Schopenhauer wrote, "Future and past are only in the concept. . . . The present alone is the form of all life, but it is also life's sure possession which can never be torn from it."¹

In short and in effect, bioethics focuses on being-in-the-world. That is a pretty big mandate. The practical result is that there is unlimited opportunity for innovation and development of outside-the-box solutions to real-world problems. For example, the health care system is desperate for impactful and visionary leaders. In the United States we have several dozen, possibly more. Yet the actual need is for hundreds, even thousands, of such leaders, operating in government, industry, higher education, health care delivery complexes, and non-profit policy centers.

Bioethical conundrums abound, including

• The six-figure-plus annual costs of many cancer medicines
• The ongoing lack of access to and availability of HIV medication in Africa and Southeast Asia.
• Access and availability of health care services, worldwide
• The moral status of the embryo and the ethics of embryonic stem cell research
• End-of-life decision making
• Prenatal genetic testing and counseling. Reproductive freedom, including IVF, same-sex parenting, and surrogacy

The world of bioethics is as big and broad, as deep and rich, as extensive and wide-ranging as the world we live in. The problems and challenges of humans (as the presumptive stewards of the planet) are the problems and challenges of bioethics. The historical four principles of bioethics—autonomy, beneficence, nonmaleficence, and justice—provide a firm foundation for this next generation of work to be done. These principles represent a launching pad for a new phase of endeavor. A phase in which bioethics can provide insight, guidance, and action steps to facilitate the thriving of all species, inclusive of our entire ecosphere.

¹Schopenhauer A: The World as Will and Representation, Vol. 1, p 278. New York, Dover Publications, 1969

The Alden March Bioethics Institute offers graduate online masters in bioethics programs.  For more information on the AMBI master of bioethics online program, please visit the AMBI site.

In a discourse between bioethicists Arthur Caplan and Robert P. George, they expound upon the false duality of “normativity” versus “scientism”. This exchange is quoted in Public Discourse under the title “Stem Cells: The Scientists Knew They Were Lying?” by Sherif Girgis, which can be found at this link and further discussed in Bioedge found here.

Wikipedia states “scientism is the idea that natural science is the most authoritative worldview or aspect of human education, and that it is superior to all other interpretations of life.”  The distinct impression one obtains from this discourse is that “scientism”, generally used as a pejorative term, is a widespread belief among scientists. In fact, scientism is a term used primarily by philosophers of science to criticize scientists.

Caplan, a generally liberal bioethicist from the University of Pennsylvania, and George, a conservative bioethicist from Princeton University rarely agree. But they seem to find common ground in agreeing that scientists, relying on scientism, are limited in making ethical determinations. They therefore need normativity imposed on them presumably by bioethicists (I admit I draw some of these conclusions which are implied rather than stated explicitly). They single out equally renowned bioethicist Ezekiel Emanuel, who Caplan identifies as an “an exemplar of scientism”.

A New York Times article, found here, regarding the current state of dialysis in this country was worth reading. However what was even more interesting (to me) was the range of comments that were subsequently submitted. The article recalled that dialysis as a treatment for end stage renal disease was first instituted in the 1960s as a life saving treatment which was intended to get patients back on their feet and return to the workplace. Today, it is used primarily in the elderly population and often in conjunction with other major co-morbidities, at times to stave off the grim reaper for a short time. The author questions whether this expensive intervention is in the best interest of the patient, or the best allocation of scarce resource dollars. 

Many of the comments agreed with the suggestion for a second look, given the limited benefits and the enormous costs of the expanded base. Others wrote that limiting life sustaining treatment was an immoral act; that targeting the elderly was patently unfair; that if we started limiting this service, it would be the first step down the slippery slope; and of course the ever present voice that we could have unlimited care if only we cut defense spending or foreign investment. 

What continually astounds me is the view that limits are unacceptable, yet we cannot expect taxes to rise and we should be prepared for decreases in government health care budgets. So who is supposed to pay? Somehow the rights of individuals always trump that of the society. No one can put a price tag on a life. If my demented 90-year-old mother can live another month with dialysis, she should be entitled, so the argument goes. As medical care has continued to expand with ever more expensive drugs and equipment, costs have risen dramatically. There are still, as we know , millions without any coverage as well as the insured who are being asked to pay larger premiums, as one would expect, to keep up with the rising costs.  Small businesses and state governments are struggling with these increases to the point of crisis. It would seem that distributive justice would dictate first, access to all and then fair distribution of services that we can afford. Any way we cut it, there are limits. Why should any group be exempt?

If you have taken a course in the philosophy of science or have thought about the essential characteristics of science you know that the scientific method is the foundation of how we distinguish scientific knowledge from mere opinion. Fundamental to scientific method is the assumption that the results of a valid study must be replicable. That is, according to the scientific method, the results of a research study that are statistically significant, i.e. not likely to be a random outcome, should be replicable in future studies using the same procedure. It is just assumed that similar results will be replicated if the study is repeated. Maybe this is why most studies with significant results are not replicated. Quite interestingly, many statistically significant results are now being shown actually to be more difficult to replicate, so claims an article called "The Truth Wears Off: Is there something wrong with the scientific method?" by Jonah Lehrer, in the December 13, 2010 issue of The New Yorker. In this article Lehrer discussed the phenomenon referred to as the “decline effect’ which purports to show from a wide range of studies that some of “our facts are losing their truth”. Perhaps this is an interesting article worth thinking about more?